Limity radikální prostatektomie

MUDr. Petr Filipenský, Ph.D.

Doctoral thesis

Limits of radical prostatectomy

Abstract:

Cílem této práce - Limity radikální prostatektomie - bylo na základě retrospektivní analýzy klinických parametrů souboru 219-ti pacientů, kteří byli operováni na Urologickém oddělení Fakultní nemocnice u svaté Anny v Brně v období od září 1999 do dubna 2003 pro lokalizovaný karcinom prostaty, předpovídat dlouhodobé funkční a onkologické výsledky. Analyzovanými klinickými parametry byli věk a hodnota BMI v době operace, dálehodnota PSA před operací, hodnota PSA v období 1, 3, 6, 12, 18 a 24 měsíců po operaci, kontinence v období 1, 2, 6, 12 a 18 měsíců po operaci, IIEF (International Index of Erectile Function) v období 1, 3, 6, 12 a 18 měsíců po operaci, Gleasonovo skóre z definitivního histologického vyšetení, délka hospitalizace a peroperační krevní ztráty. Pro predikci složitějších závislostí u některých funkčních a klinických parametrů (restituce potence, obnova kontinence a PSA relaps) byly pro předpověď funkčních výsledků využity umělé neuronové sítě.

Abstract:

We evaluated long term oncological and functional results in set of 219 patients underwent retropubic radical prostatectomy (RRP) for organ confined prostate cancer since September 1999 to April 2003. All the procedures were performed in Department of Urology, St. Anns Teaching Hospital in Brno. Novel prediction tool was created for next patients suffering from localized Prostate Cancer. In the first part of these study are evaluated clinical parameters of our 219 patients retrospectively. These clinical parameters were evaluated: age of patients, Body Mass Index, PSA value prior surgery, PSA value during 1, 3, 6, 12, 18 and 24 months after surgery, urinary continence during 1, 2, 6, 12 and 18 months after surgery, erectile function 1, 3, 6, 12 and 18 months after surgery, Gleason score of final specimen, duration of hospital stay and peroperative blood loss. For prediction of more complicated relations of functional and oncological results were used Arteficial Neural Networks (ANN). For purpose of this study were gained clinical, pathological data and data after surgery. Clinical characteristics of each individual were evaluated in time of diagnosed Prostate Cancer and included patients age, race, height, weight and PSA value. Pathological stage and Gleason score were used from final pathological examination of specimen. Relations among several evaluated clinical parameters arent linear, for prediction of long term results were used ANN. Created prediction tool is able to predict two most important functional results: recovery of continence and restitution of erectile function. For each predicting parameter was set optimalized structure and architecture of ANN. In prediction of oncological results we were aimed biochemical recurrence (PSA relaps). In prediction of all these mentioned above parameters was relative risk less than 5%.

Keywords

karcinom prostaty, RRP, ANN, onkologické výsledky, funkční výsledky prostate cancer, oncological results, functional results

Language used: Czech

Date on which the thesis was submitted / produced: 5. 4. 2006

Thesis defence

• Date of defence: 22. 6. 2006
• Supervisor: prof. MUDr. Jan Wechsler, CSc.

Masaryk University

Faculty of Medicine

Doctoral programme / field:
General Medicine / Surgery